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The term uveitis is
used to describe inflammation of one or more tissues of the uveal
tract of the eye. The uveal tract is the vascular, pigmented, middle
layer of the eye and is composed of anterior uvea, which includes the
iris and ciliary body, and the posterior uvea or choroid. There is no
physical barrier between the anterior and posterior uvea; they are
continuous with one another and as a result inflammation often
involves both anterior and posterior segments.
Many internal and
external pathophysiologic processes can result in uveal damage and
trigger an inflammatory response. These processes include both local
and systemic infections and sepsis as well as head/eye trauma,
vasculitis, bleeding disorders, immune diseases, neoplasia and, most
frequently, idiopathic bases.
The spectrum and
magnitude of clinical signs depend on the severity of the cause of
inflammation. Uveitis can be painful if it is acute or due to
trauma. Chronic uveitis can lead to formation of synechia (adhesions)
that can obstruct aqueous humor outflow, causing secondary glaucoma.
As a result the eye(s) may show any or all of the following signs:
- Constricted
pupil(s)
- Redness
around or within the eye
-
Discolored/swollen iris
- Cloudiness
within and/ or under the cornea
- Sunken globe
- Vision
impairment
- Unequal
pupils
- Excessive
blinking/squinting
- Distorted
pupil shape
- Swollen globe
(with secondary glaucoma)
Although it is
often not possible to identify the underlying source if inflammation,
some baseline tests are necessary to rule out certain traumatic,
infectious and neoplastic causes; and, if a specific pathogenesis can
be identified and treated, the prognosis improves. Initial testing
will include:
-
Thorough physical
and ophthalmic examinations
-
Intraocular
pressure measurement
-
Fluorescein
ophthalmic stain
-
Felv & FIV testing
-
Baseline blood work
and urinalysis
The goals of
treatment are to:
This is achieved
with topical and systemic anti-inflammatory medications (usually
steroids) along with topical atropine as need to prevent adhesions and
relieve pain. Recheck examinations every 1-2 days are recommended
initially to assure inflammation is under control, monitor for changes
in intraocular pressure and identify developing signs of underlying
systemic disease. Referral to a veterinary ophthalmologist may be
necessary if improvement is not rapid.
Prognosis for
vision depends on the actual condition or injury that led to the
uveitis and the extent and duration of the inflammation. In cases of
mild to moderate uveitis the prognosis for vision is usually
favorable, but severe cases have a guarded prognosis for vision and
sometimes even for the globe.
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